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Published on: December 4, 2013

Long-term neurocognitive outcomes of patients with end-stage renal disease during infancy

Rebecca J Johnson1, Bradley A Warady

  • 1Developmental & Behavioral Sciences, Children's Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64113, USA. rejohnson@cmh.edu

Pediatric Nephrology (Berlin, Germany)
|April 5, 2013
PubMed

Insights

Infants with end-stage renal disease (ESRD) show long-term neurocognitive deficits, including lower intellectual and metacognitive functioning compared to siblings. Shorter dialysis duration and earlier transplant improve outcomes.

Area of Science:

  • Pediatric Nephrology
  • Neurodevelopmental Pediatrics
  • Child Psychology

Background:

  • Infants diagnosed with end-stage renal disease (ESRD) often experience adverse short-term neurocognitive outcomes.
  • Long-term neurocognitive effects of infantile ESRD remain under-researched.

Purpose of the Study:

  • To assess the long-term neurocognitive outcomes in children diagnosed with ESRD during infancy.
  • To compare intellectual functioning, executive function, memory, and academic achievement with healthy siblings.

Main Methods:

  • Neurocognitive assessments were performed on 12 patients with infantile ESRD.
  • Nine patients (mean age: 11 years) were compared to their healthy siblings (mean age: 10 years).
  • Paired-samples t tests were used to analyze differences in cognitive measures.

Main Results:

  • Patients exhibited significantly lower Full Scale IQ (FSIQ) scores (78 vs. 94) and academic achievement (WIAT-II-A Total Achievement: 84 vs. 103) compared to controls.
  • Higher Metacognition Index scores (indicating greater risk for dysfunction) were observed in patients (61.4 vs. 46.7).
  • Negative correlations were found between FSIQ, Processing Speed, and duration of dialysis; younger age at transplant correlated with better outcomes.

Conclusions:

  • Infantile ESRD is associated with significant long-term deficits in intellectual and metacognitive functioning.
  • Reduced duration of dialysis and earlier age at kidney transplantation are linked to improved neurocognitive outcomes.
  • These findings highlight the critical need for neurocognitive monitoring and support in children with a history of infantile ESRD.
Abstract

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